| NPI | 1164865838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 35.128407) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57.022892) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2022-09-09 |